§ Rule 1920.75 Form of Inventory

Rule 1920.75. Form of Inventory

    The inventory required by Rule 1920.33(a) shall be substantially in the following form:

    (Caption)

    INVENTORY

    OF

    __________

    (Plaintiff) (Defendant) files the following inventory of all property owned or possessed by either party at the time this action was commenced and all property transferred within the preceding three years.

    (Plaintiff) (Defendant) verifies that the statements made in this inventory are true and correct. (Plaintiff) (Defendant) understands that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.

    ______________________________________

    (Plaintiff) (Defendant)

    ASSETS OF THE PARTIES

    (Plaintiff) (Defendant) marks on the list below those items applicable to the case at bar and itemizes the assets on the following pages.

    ( ) 1. Real property

    ( ) 2. Motor vehicles

    ( ) 3. Stocks, bonds, securities and options

    ( ) 4. Certificates of deposit

    ( ) 5. Checking accounts, cash

    ( ) 6. Savings accounts, money market and savings certificates

    ( ) 7. Contents of safe deposit boxes

    ( ) 8. Trusts

    ( ) 9. Life insurance policies (indicate face value, cash surrender value and current beneficiaries)

    ( ) 10. Annuities

    ( ) 11. Gifts

    ( ) 12. Inheritances

    ( ) 13. Patents, copyrights, inventions, royalties

    ( ) 14. Personal property outside the home

    ( ) 15. Business (list all owners, including percentage of ownership, and officer/director positions held by a party with company)

    ( ) 16. Employment termination benefits--severance pay, worker's compensation claim/award

    ( ) 17. Profit sharing plans

    ( ) 18. Pension plans (indicate employee contribution and date plan vests)

    ( ) 19. Retirement plans, Individual Retirement Accounts

    ( ) 20. Disability payments

    ( ) 21. Litigation claims (matured and unmatured)

    ( ) 22. Military/V.A. benefits

    ( ) 23. Education benefits

    ( ) 24. Debts due, including loans, mortgages held

    ( ) 25. Household furnishings and personalty (include as a total category and attach itemized list if distribution of such assets is in dispute)

    ( ) 26. Other

    MARITAL PROPERTY

    (Plaintiff) (Defendant) lists all marital property in which either or both spouses have a legal or equitable interest individually or with any other person as of the date this action was commenced:

    Item                          Description                                         Names of
    Number                        of Property                                    All Owners    

    NON-MARITAL PROPERTY

    (Plaintiff) (Defendant) lists all property in which a spouse has a legal or equitable interest which is claimed to be excluded from marital property:

    Item                                             Description                            Reason for

    Number                                     of Property                                          Exclusion

    PROPERTY TRANSFERRED
Person

    Item                                     Description                      Date of                  Consid-              to Whom

    Number                            of Property                              Transfer                 eration            Transferred

    LIABILITIES

    Item                          Description                         Names of                                Names of

    Number                        of Property                          All Creditors                       All Debtors